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World Health Organization (WHO): Events
where workers are Abused Threatened Physically hurt in situations related to work, including: Traveling for work, involving a threat to their safe-ty or health.
OSHA/CDC: Violent acts
including physical assaults threats of physically hurt directed toward people at work.
Bureau of Labor Statistics’ data showed the
most common cause of nonfatal injuries and
illnesses that required days off from work in
the health care industry was assault.
Verbal abuse rates were lower when emer-
gency departments had:
locked entries
an enclosed nurses’ station,
security signs
well lit areas.
Physical violence were
lower in emergency
rooms with panic but-
tons.
In hospitals with higher commitment to
safety and reporting policies, particularly
with ,
had lower rates of physical
and verbal abuse.
Lancman, S., Mângia, E. F., & Muramoto, M. T.
(2013). Impact of conflict and violence on
workers in a hospital emergency room.
Work, 45(4), 519-527. doi:10.3233/WOR-
131638
Wolf, L. A., Delao, A. M., & Perhats, C. (2014).
Nothing Changes, Nobody Cares: Under
standing the Experience of Emergency
Nurses Physically or Verbally Assaulted
While Providing Care. JEN: Journal Of
Emergency Nursing, 40(4), 305-310.
doi:10.1016/j.jen.2013.11.006
Pacing and/or restlessness
Clenched fist
Loud speech
Excessive demands
Threats
Cursing
Respect Personal Space
Do not be challenge agitated person
Begin verbal communication
Identify wants and feelings
Be short and to-the-point
Listen to what they have to say
Agree or agree to disagree
Lay down law and set clear limits
Offer choices and optimism
interview the patient and staff
Warning Signs of
increasing violence
Main objectives when
dealing with an agitated
individual
1. ensure the safety of the pa-
tient, staff, and others in
the area
2. help the patient handle
their emotions and main-
tain or regain control of
his behavior
3. avoid the use of restraint
(if at all possible)
4. avoid forced influence that
increases anger
Verbal De-escalation
Guidelines
Security Measures to
Improve Staff
- Concealed panic buttons -In nurse’s stations, on staff, in check-in areas -Notify security when pressed -Improve lighting and video surveillance - Limit access to ED area - Waiting room with controlled access to the ED - Doors only used for emergency exits - Escort or buddy system
Over 70% of emergency nurs-
es reported physical or verbal
attacks by patients or visitors
while they were providing pa-
tient care in the emergency
room. Emergency Department Violence: An overview and
compilation of Resource. (2011, April 1). Re
trieved March 13, 2015, from http://
www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=1&
ved=0CCQQFjAA&url=http://www.acep.org/
content.aspx?
id=81782&ei=WDYDVYXzFOvdsATXjIHgAQ&u
sg=AFQjCNE2kqtt8Ntb4MpGqWrL15jR7wxjk
w&sig2=uTgO97kfeiNU3FraVsr3XA&bvm=bv.
88198703,d.cWc
Speroni, K. G., Fitch, T., Dawson, E., Dugan, L., &
Atherton, M. (2014). Incidence and Cost
of Nurse Workplace Violence Perpetrated
by Hospital Patients or Patient Visitors.
JEN: Journal Of Emergency Nursing, 40(
3), 218-228. doi:10.1016/
j.jen.2013.05.014